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Services Request Form

Individual Services

Please use this form to request services from the Oregon Commission for the Blind for yourself, a relative, a friend, or a client.
NOTE: The Oregon Commission for the Blind can only disclose information about a client’s applicant status if we have a Release of Information (ROI) form signed by the client. If you or your agency anticipates coordination of care, in order to establish informed consent at referral, submit this form and email a ROI form signed by the client to ocb.mail@ocb.oregon.gov. Thank you.

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